How much rates vary
Facilitymedian $1,175 · 10th to 90th $759 to $2,344Professionalmedian $2,291 · 10th to 90th $1,175 to $3,090
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $1,000.00 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,995.26 | $2,570.40 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,398.83 Median $3,090.30 Typical High $3,630.78 | Professional | 22 · Increased work | $2,398.83 | $3,090.30 | $3,630.78 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,819.70 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,412.54 | $1,819.70 | $2,137.96 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $257.04 Typical High $309.03 | Professional | 56 · Pre-op care only | $199.53 | $257.04 | $309.03 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,949.84 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,949.84 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Facility | None | $1,949.84 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,187.76 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,398.83 | Facility | None | $758.58 | $1,174.90 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,041.74 Typical High $8,709.64 | Professional | None | $954.99 | $2,041.74 | $8,709.64 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,344.23 | Professional | None | $977.24 | $1,659.59 | $2,344.23 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $213.80 |
Where North Dakota sits
The same service costs 5.9 times more in Alabama than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AL $10,682MD $1,821
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.